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HomeMy WebLinkAboutDOHN CONSTRUCTION INC - INSURANCE CERTIFICATE (4)DOHNCON-01 LPREWITT FACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 06114/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: PFS Insurance Group PHONE 4848 Thompson Parkway Suite 200 (A/C, No, Ext): (970) 635-9400 (A/c, No):(970) 635-9401 Johnstown, CO 80534 ADDRE : info@mypfsinsurance.com INSURED Dohn Construction, Inc. DCI Residential, LLC 2642 Midpoint Drive Fort Collins, CO 80525 D: INSURER F : Mutual Casualtv Corn ^E!MTIMI ATn KII Iaao Co. OC\/ICInKI IJI IMRFA- 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ] OCCUR Blanket Addl Insured 1R57255 10/01/2017 10/01/2018 EACH OCCURRENCE $ 1,000,000 DAM AGE TO RENTED PRE E a occurrence 100,000 $ X MED EXP An one person)$ 5,000 X Blanket Waiver PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY a PE&_ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -AWNED AUTOS ONLY AUTOS ONLY Blanket Addl Blanket Waiver X Insured X 1Z57255 10/01/2017 10/01/2018 Ea NED acclidentSINGLE LIMIT $ 1,000,000 BODILY INJURY Per arson $ BODILY INJURY Per accident $ PpReOPPcERde tDAMAGE $ - $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1P57255 10/01/2017 10/01/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ WFICER/MEMBEREXCLUDED9 Wein NH) If ycs, describe under DESCRIPTION OF OPERATIONS below N/A 3055407 07/01/2018 07/01/2019 X PER OTH- STATUTE R E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Installation 1057255 10/01/2617 10/01/2018 $1,000 Deductible 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD